Cancer Patient Experience

Eric Ollerenshaw Excerpts

Wednesday 30th October 2013 Westminster Hall

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

I would like to think that I take the message, Mr Owen. It is a pleasure to serve under you.

It is also a pleasure to congratulate the new Minister, my hon. Friend the Member for Battersea (Jane Ellison), on her appointment. She has a reputation as a listening Minister and I am sure that, when she makes her closing remarks, she will prove to have listened to all of us here today.

I start off in a very partisan situation. As the hon. Member for Strangford (Jim Shannon) said, we are getting to the “cancer world”, as I call it; it is like a separate world that involves different people, often through personal experience. My experience of it is personal, but also through being secretary of the all-party group on pancreatic cancer. If I may, Mr Owen, I will give a little plug here—the all-party group is producing a report, which the Secretary of State for Health has agreed to take at a meeting on 25 November. All hon. Members will be invited to that meeting.

The report is about improving outcomes. I congratulate my hon. Friend the Member for Hertsmere (Mr Clappison) on securing this debate at this timely moment. What we in the all-party group are trying to see is a further improvement in outcomes, at a time when outcomes for cancer patients are improving. When I was growing up in the 1950s and 1960s, if somebody mentioned the word “cancer” it was almost as if a life sentence had been passed. We are in a different situation now.

Pancreatic cancer is seen as perhaps the most difficult cancer, and there are issues connected with that. I will cite some statistics to demonstrate the situation that pancreatic cancer patients often find themselves in. My hon. Friend the Member for Basildon and Billericay (Mr Baron) is far more experienced in this area than I am, and he put his finger on the issue by stressing the importance of early diagnosis.

I will give the figures from the national cancer patient experience survey: 40% of pancreatic cancer patients visited their GP three or more times before diagnosis; and 25% visited their GP five or more times before diagnosis. Those figures compare with 75% of all other cancer patients who are referred to hospital after one or two GP visits.

From the investigation that the all-party group made, I can cite the specific example of someone who came to us to give their own personal experience. They said:

“With regard to early diagnosis, the most important aspect for us was the fact that Gemma went to her GP on a total of 10 separate occasions between the middle of April 2009 and the end of August, when she was finally referred to a specialist”.

That is the experience of most people with pancreatic cancer. In my own case, I think that my partner went to the GP six or seven times before somebody then said, “Better go to a hospital.”

Then, when a patient gets to the hospital situation, quite often there is no access to a specialist in pancreatic cancer. If a clinical nurse specialist is not available, the patient is even more lost. I underline the importance that the all-party group attaches to the clinical nurse specialist in almost holding the hand of somebody with cancer as they go through the system.

[Andrew Percy (Brigg and Goole) (Con)]

I want to tell my hon. Friend about a meeting that I had with a radiotherapist in my constituency just a week or two ago. They told me that, all too often, patients who appear for treatment tell him that they visited their GP on numerous occasions and, sadly, often they were sent home. I know that it is incredibly difficult for GPs. We are expecting a lot of them, but there is still a lot more to be done in ensuring that GPs across the country are consistent in their approach to people who present with certain symptoms.

[Eric Ollerenshaw]

My hon. Friend is absolutely right and I totally agree with him. That is the kind of information that we, as an all-party group, have been receiving from right across the country.

As I said, there is a lack of specialism, even in a hospital situation sometimes. The issue with pancreatic cancer is that there is a repetition of non-specific symptoms. Again, I cite my own personal experience from the case of my partner—he just had a stomach ache that went on and on, without a particular issue. Other hon. Members have referred to what males tend to do, and they are absolutely right; we often put these things to one side and say, “It is a stomach upset”, despite the repetition of symptoms. What we are trying to get GPs to look at is this: if they are seeing somebody who has never been to them before, somebody who never really goes to a GP but keeps turning up, an alarm bell should be sounding.

I will cite some other figures, although I am aware of the time factor. Some 33% of pancreatic cancer patients feel that they have been given conflicting information, compared with 29% of all other cancer patients. Some 13% of pancreatic cancer patients did not get answers to important questions all or most of the time, compared with 9% of all other cancer patients. Some 36% of pancreatic cancer patients felt less likely to feel that their views were being taken into account by doctors and nurses when discussing treatment, compared with 30% of all other cancer patients.

As I said, I am being totally partisan. The all-party group’s experience and my experience personally is that, for some reason, this country is way down the line on pancreatic cancer—despite it being the fifth biggest cancer, in terms of the number of people who die from it—when it comes to international comparisons for improved outcomes. There are treatments, but far too often they are far too late, because of people’s constant appearances at GPs.

Other Members have talked about dignity and humiliation. I will be utterly personal about the issue, because, in one sense, that is what has driven me to get so involved. I remember my partner’s situation. It was a case of finally going to hospital, being told that people there would do some tests and then that they would carry out an operation because they thought it was cancer. “What does that mean?” We did not know.

I can remember being sat in the hospital and my partner coming back, straight from surgery, with things wrapped round. We said, “What is it?” The doctor turned round and said, “Oh, it’s terminal.” That is the kind of situation that happens. Where is the understanding? Where are the few minutes where they say, “Let’s just go through this. Let’s look at the options”?

I understand that people working in hospitals are under pressure, but there were repeated examples of such experiences at the all-party group. As other hon. Members, particularly those from Northern Ireland, have said, a person should not have to be brain of Britain or have gone on a training course to have a little more time and to treat people with a little more dignity.

I finish with two particular demands, or requests, for the Minister. The all-party group wants consideration to be given to an awareness campaign, particularly about pancreatic cancer. I add my praise for the involvement of Macmillan and Pancreatic Cancer UK, which is the charity that backs up the all-party group and continues to support us, in terms of the campaign on awareness.

Macmillan has been piloting decision tools to help GPs assess the risk of cancer, including pancreatic cancer, and make decisions about further referrals. We would like to see those properly evaluated with consideration given to a full roll-out of the pilots that Macmillan has been spearheading so fantastically.

We have also been trying to raise awareness that pancreatic cancer is not an old man’s disease, in crude terms. The risk increases with age, but 35% of all diagnoses of pancreatic cancer occur in people under the age of 65—that is about 3,000 of the 8,500 diagnosed each year. The split among men and women is reasonably even, with slightly more cases in women than in men. I am not sure that that is clear, so that would be part of what we would request in a campaign. It would lead to greater awareness and, hopefully, earlier referrals and better outcomes.

My final request relates to the national cancer patient experience data. Pancreatic Cancer UK paid for a separation of data for pancreatic cancer patients—in fact, the Department of Health paid for that to be done once. We would like pancreatic cancer patients to be routinely separated out from all upper-gastrointestinal cancer patients as part of the system of getting such statistics. I do not see why a charity or the Department should try to do that as an extra thing. It should be part and parcel of the routine, given the nature and impact of this dreadful, increasingly misunderstood cancer.

Care Quality Commission (Morecambe Bay Hospitals)

Eric Ollerenshaw Excerpts

Wednesday 19th June 2013 Commons Chamber

[Mr Hunt]

I welcome much of what the right hon. Gentleman says, but let me say this: he talks about getting on with implementing the Francis report, and that is exactly what has been happening. The report came to the House on 6 February. A new chief inspector of hospitals was appointed by 31 May, and the new inspections will start towards the end of this year. That will mean that many of the things talked about in the Francis report as being fundamentally important will start to be looked at independently and rigorously for the very first time.

I can confirm that there will be a duty of candour in the new Care Bill. We are looking at the extent to which it should apply to individuals, but we want to wait until Professor Berwick produces his report, because it is important to create a culture of openness, and we do not want to pass a measure that might inadvertently mean people clam up when they see a potential safety breach. We need to encourage an atmosphere where everyone talks openly about any concerns they have.

David Prior will be looking in his response to today’s independent report at whether anyone still working in the NHS, or, indeed, the CQC, may have been responsible for some of the shocking things that have been revealed. He will pass that report to me within the next two months. As I said in my statement, there will be full consideration of any sanctions or appropriate disciplinary procedures. In our response to the Francis report, we have said we want to introduce a new barring scheme to make sure that managers who have been found guilty of behaving in a bad way do not get jobs in another part of the NHS.

With respect to what the right hon. Gentleman said about my colleague, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), I gently say to him that it was not my right hon. Friend or myself or this Government’s Ministers who rejected 81 requests for a public inquiry into what happened at Mid Staffs. My right hon. Friend was the person who called the public inquiry into Mid Staffs. He is the person who changed the management of the CQC. He is the person who put clinicians in charge of budgets in the NHS, precisely to make sure these kinds of safety issues do not arise.

Finally, the right hon. Gentleman talks about accountability. If the Opposition really wanted to give confidence that they take the issues raised today seriously, they would recognise that it was fundamentally wrong to set up an inspection regime that was not carried out by specialists, and where the same person was inspecting a dental clinic, a slimming clinic, a hospital or a GP practice, perhaps in the same month. That may have contributed to the CQC’s decision in 2009 not to investigate the maternity deaths at Morecambe Bay, and to its decision in April 2010 to register the hospital without conditions.

When it comes to accountability, the right hon. Gentleman needs to explain to the House why the former head of the CQC, Barbara Young, said in her evidence to the Francis inquiry:

“We were under more pressure…when Andy Burnham became minister, from the politics.”

Is it the case that the head of the CQC felt under pressure not to speak out about care issues?

On the substantive policy point, the right hon. Gentleman continues to criticise the appointment of a chief inspector of hospitals and continues to criticise me when I single out hospital management who coast when it comes to raising standards. Just how much evidence will it take for the right hon. Gentleman and the Labour party to realise that when it comes to NHS policies, they really need to change?

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

As Member of Parliament for Lancaster, which is covered by the Morecambe Bay trust, may I reassure the Secretary of State and the House in general that thousands of my constituents are receiving a good service from hundreds of hard-working NHS doctors and nurses at the Royal Lancaster Infirmary? Does he think the problems began with the setting up of the CQC on 1 April 2009, and its being appointed as an independent regulator and being expected by the previous Government to inspect and register 378 NHS trusts within 12 months, by April 2010, which was an impossible target for any system to cope with?

[Mr Hunt]

My hon. Friend is absolutely right. That regime was utterly flawed, and as far as we can tell, inspectors looking at hospitals and care homes had targets of inspections they had to complete in a way that was totally counter-productive to the concept of a rigorous, thorough, independent inspection where people speak out without fear or favour when they find problems.

I also thank my hon. Friend for the other point he makes: that the people who work at the University Hospitals of Morecambe Bay NHS Foundation Trust are working extremely hard and under great pressure. I think they are doing a very good job by and large, but there are clearly very severe problems with the trust that we need to get to the bottom of, and it is very important that we recognise that if we are going to create a safety culture in the NHS, we need to back the people on the front line. They did not go into the NHS to have to deal with these terrible breaches in health and safety; they went into the NHS because they care for people and they want to do the best for people at their most vulnerable.

Accident and Emergency Waiting Times

Eric Ollerenshaw Excerpts

Wednesday 5th June 2013 Commons Chamber

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

I have only a brief amount of time, so I will not repeat what other Members have said about demographics. I would also have liked to have talked about the NHS funding formula and the fact that Lancaster and Fleetwood is a rural area and there is no accounting for geography or the numbers of old people.

I agree with the hon. Member for Southport (John Pugh) and others who said we need a non-political debate. I shall focus on the question of staffing in A and E. People talk about crisis and chaos, but the majority of my electorate get a very good service from highly qualified professionals, who are working extremely hard. There is a staffing issue, however: we need to ensure there are enough properly qualified emergency specialist consultants working in A and Es both now and in the future and that they are not stretched to breaking point.

All this information comes from the doctors working in my A and E at the Royal Lancaster. This issue was also flagged up in a College of Emergency Medicine report, “The drive for quality”. The problem, which has been building over many years, is that ever fewer doctors want to move into the A and E specialty. That is largely because of the pressures of the work and the long and unsociable hours, including high-pressure weekend shifts that do not arise in other specialties. In turn, that leads to even more pressure on the few qualified consultants that remain, who have to work longer shifts and take on ever more responsibilities, and many of whom therefore eventually choose to go into other specialties as well. As a result, there is always a shortage of specialists.

To see how bad the problem was, I submitted a series of freedom of information requests last year, asking hospitals how many consultant emergency physician vacancies they had and how many people had applied for posts when they were last advertised. There seemed to be some regional variations—and my area, the north-west, seemed to be having particular difficulties—but there were some worrying general trends. Without naming individual hospitals, here are some examples: one hospital advertised for a senior clinical fellow on three separate occasions over the course of nine months, but there were no suitable applicants; another hospital advertised for three consultant emergency physicians, but no one applied; elsewhere, seven consultant vacancies were reported in one hospital, representing some 33% of its planned consultant staffing rate.

Even when there are applicants, competition is fierce. One hospital advertised for six vacancies and received four applications, but three of them withdrew prior to interview, presumably because they had been poached by employers elsewhere. Worryingly, sometimes the quality of applicants is not up to standard, as in the case of the hospital which advertised for five consultant emergency physician vacancies, only to conclude that none of the applicants was appropriately qualified.

I again stress that, according to the College of Emergency Medicine, this issue has been worsening over many years. We need to work constructively to ensure that emergency physician status is better recognised and rewarded within the NHS, so it can recruit and retain the required quality staff. This might not all be about money, by the way, but we definitely need to do more to tackle the issue and to give due credit and due status to the physicians who maintain the existing A and E service—which, as I have said, for the majority of my constituents is a good service.

Health and Social Care

Eric Ollerenshaw Excerpts

Monday 13th May 2013 Commons Chamber

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

I am pleased to follow the hon. Member for City of Durham (Roberta Blackman-Woods), who picked up the theme of the hon. Member for Bradford East (Mr Ward) in talking about social care, which I too should like to remark on.

Unlike others, I will not be tempted into the subjects of tobacco, Europe or gay marriage but will stick fundamentally to the title of this debate on health and social care. I have a few specific points to make about the impact on my constituency. In general, though, I am proud to be part of a Government who, despite the need to eliminate the huge budget deficit left to us, have protected spending on the NHS. That has been necessary, in large part, because of the demographic changes that are happening in the UK with a rapidly ageing population. We need to do more than just target health spending on the older population; we need to change the way we think about providing care for the elderly and what this means for our society. I think that that is what other hon. Members are working towards as regards the cross-over between social care and health care.

I warmly welcome the inclusion of the Care Bill in the Queen’s Speech and the Secretary of State’s comments about personal health care and social care plans for the elderly. We can all make criticisms in saying that more should have been done, but the fact is that this Government have actually done it. The previous Government kept promising to do something about the tragedy of people having to sell their homes to pay for care; this Government have set about doing it by introducing a Bill that will end that tragedy by introducing a cap on care costs. That is remarkable given the background of the deficit we face. The implications of that will be borne out when the electorate understand that finally a Government have committed to go this far.

I firmly believe that this is the right way forward. It has been clear for some time that we needed to create a long-term solution to allow people to plan with confidence for their future. Now other generations, too, can plan how they want to look after themselves in old age because they know that the cap is there and that there will be a higher means-testing threshold allowing them to put some money aside to address these issues. We have already heard in this debate arguments about the threshold, the cap, and the way forward. However, I hope that Labour Members will recognise that, as the right hon. Member for Leigh (Andy Burnham) and the hon. Member for Worsley and Eccles South (Barbara Keeley) indicated, we need to find a bipartisan way to deal with this fundamental demographic issue facing the population of this country and try to shift it out of the political arena.

Having talked about social care, I now want to address NHS funding more broadly. As I have said, I am proud that NHS spending has risen in real terms over the life of this Parliament, but the historic formula used to distribute NHS money around the country needs to be reassessed. Although it is correct to factor in depravation when deciding where funds are allocated, a bigger weighting needs to be given to the age of the local population. A recent Age UK briefing note stated that at any one time about 65% of hospital patients will be over the age of 65, while, according to national statistics, areas with the highest depravation are also likely to be those with the youngest population. At present, therefore, those parts of the country with the highest numbers of older people have to deliver highly specialised services and care without a funding formula to assist them in their work. Moreover, as a Member representing a semi-rural part of the country, I see at first hand the effect that geography also has on the delivery of services and the extra costs involved in delivering quality health care over a wide area.

Lancaster is part of the Morecambe Bay NHS Foundation Trust. It is a pleasant and wonderful geographical area, but it is enormous. It has three hospitals—in Lancaster, Barrow and Kendal. The distance between the hospital in Barrow, which offers some specialist services, and that in Lancaster, which offers others, is 50 miles by car, but the hills and dales mean that it sometimes takes one and a half to two hours to travel between the two. Nothing in the national formula acknowledges the problems faced by the trust. Specialist services need to be retained in as many of those hospitals as possible if journey times are to be kept to acceptable levels, which means that they will require proper funding to allow them to operate. I look forward to working with my hon. Friends the Members for Suffolk Coastal (Dr Coffey) and for Beverley and Holderness (Mr Stuart), as well as others, to try to tackle this unfair disparity with regard to some geographical areas.

I want to pinpoint how the problem affects us locally. The Royal Lancaster Infirmary has a vascular service unit and, despite the excellent clinical outcomes it has delivered for years, it has been suggested that it should close. That would leave a service gap between Carlisle in the north and Preston in the south of nearly 90 miles. It would leave patients from the more rural parts of my constituency, especially those from Barrow or south Cumbria, with lengthy journeys if they needed specialist treatment. Some areas are well outside the 90-minute transport target time, which is already an extension of the national target of 60 minutes.

That delay in journey time is a genuine issue for consideration when establishing where specialist services should be located, as has already been proven by the decision to retain a vascular service in Carlisle, where an exception was made to most of the scoring criteria because of the local geography and the time it would take to transport patients elsewhere. If exceptions are rightly being made in one part of the north-west, they should apply to other areas where substantial delay is likely to occur. As I have already said, under the current plans there is a huge geographical gap in service provision between Carlisle and Preston.

The closure proposal has been referred to the Secretary of State for a final decision and I sincerely hope that he and his Ministers will decide in favour of retaining the specialist provision at the RLI. That, however, is just one example. A more wide-ranging review is being undertaken of service provision across north Lancashire and there are concerns that our local A and E unit may be under threat as a result of geography not being taken into account.

The funding formula needs to change to take greater account of those parts of the country with an elderly population. It also needs better to reflect the difficulties of providing services in large geographical, sparsely populated areas. Without that and the accompanying reallocation of resources, hospitals in rural and semi-rural areas will struggle even more to provide the necessary services to their residents. I urge the Secretary of State to look into this as a matter of urgency.

Oral Answers to Questions

Eric Ollerenshaw Excerpts

Tuesday 16th April 2013 Commons Chamber

[Anna Soubry]

I have to tell the hon. Lady that, as she knows, there is some controversy over this treatment, which is backed by a very large and powerful American company. The Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), has visited, and I know that the Secretary of State has an extremely busy and full diary. It is not as simple as a visit; it is all about whether there is any clinical value.

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

3. What steps his Department is taking to raise awareness of the signs and symptoms of cancer.

[Steve Brine (Winchester) (Con)]

8. What steps his Department is taking to raise awareness of the signs and symptoms of cancer.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It would take me a very long time to give all the details of the Department’s work. In short, we have run a number of specific campaigns, both locally and regionally, to deal with a number of cancers. We will now evaluate whether those pilots have been successful. What I can say is that, such is the success of the lung cancer campaign, we will be recommissioning it in July.

[Eric Ollerenshaw]

I thank the Minister for that reply. May I raise, in particular, the issue of poor outcomes in pancreatic and prostate cancer? The problem we face is how to achieve the earlier diagnosis that is needed by GPs, so that we can achieve better outcomes in terms of international comparisons.

[Anna Soubry]

It was a great pleasure to meet my hon. Friend and the hon. Member for Scunthorpe (Nic Dakin) to discuss prostate and pancreatic cancer. Those cancers are difficult because often the symptoms are not obvious. The “Know 4 sure” campaign highlights some of the symptoms associated with them. We are evaluating this matter, and if we think that there is benefit in a campaign specifically on those cancers, we will run it.

Fetal Anti-convulsant Syndrome

Eric Ollerenshaw Excerpts

Tuesday 26th March 2013 Westminster Hall

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

I congratulate the hon. Gentleman on securing this important debate, and I add my thanks for the tenaciousness of Janet Williams, who is one of my constituents. In a sense, her work mirrors some of my work with the hon. Member for Heywood and Middleton (Jim Dobbin) and the all-party group on tranquilliser addiction.

The hon. Member for Glasgow Central (Anas Sarwar) hits the precise point on the licensing of these drugs and their side effects. General practitioners need to have knowledge of those side effects and transfer that knowledge to the patients to whom they dish out the drugs. Has he any suggestions for how we might tighten that up, or at least tighten up the knowledge among GPs of what they are actually prescribing?

[Anas Sarwar]

The hon. Gentleman is very lucky to have such a fantastic constituent who has put so much fantastic effort, energy and hard work not only into her own personal circumstances but into getting justice for families across the country. That says a lot about his constituent, and he is a very luck man in that sense. There clearly needs to be better guidance for GPs, and in a second I will make some suggestions and ask direct questions of the Minister on that topic.

From the early 1990s, Sanofi continually insisted that patients consult their doctor when taking Epilim during pregnancy, which is standard for a patient information leaflet. In 2005, it added this to its patient information leaflets:

“Some babies born to mothers who took Epilim during pregnancy may develop less quickly than normal and may require additional educational support.”

In 2011, Sanofi added:

“Some babies born to mothers who took Epilim…during pregnancy may develop less quickly than normal or have autistic disorders.”

Sanofi therefore recognised in 2005 and 2011 that its drug can have a negative impact on a foetus. Why did that take so long?

Research by a group of six academics from the universities of Liverpool and Manchester was published this year, and it concludes that if sodium valproate

“is the treatment of choice, women should be provided with as much information as possible to enable them to make an informed decision. This should take place prior to conception as the evidence suggests that the neuropathology of Autism Spectrum Disorders develops early in gestation. Further, these findings have implications for the care of children with a history of prenatal exposure to Anti-Epileptic Drugs (AED). Children exposed to AEDs in utero, particularly Sodium Valproate (VPA), should be monitored closely during early childhood to allow for early intervention, diagnosis and support, should it be required.”

There are many pieces of similar medical research, but it would be difficult to go through all of them and their findings in the short time available.

The personal story of a young constituent of mine compelled me to initiate this debate. When he was born in 1997, he was immediately taken to a special baby care unit because his body was very floppy. In 1998, he was diagnosed with pneumonia and stayed in hospital for 10 days, at which point he was diagnosed with dextrocardia, which is a congenital defect affecting the heart. In 2001, he started nursery and showed signs of regression. He lacked co-ordination and was unable to handle his emotions, as a result of which he was given a preliminary diagnosis of fetal valproate syndrome, another name for fetal anti-convulsant syndrome. He was then given a firm diagnosis by a geneticist at Glasgow’s Yorkhill children’s hospital.

In 2002, my constituent started primary school and was given a special educational needs teacher. The same year, he was admitted to hospital for surgery on his tonsils and adenoids and had grommets inserted. In 2003, he was admitted to hospital with problems going to the bathroom that required surgery. He was diagnosed with pneumonia again, and with primary ciliary dyskinesia, a genetic disorder affecting the respiratory tract. He was put on a repeat prescription of antibiotics to prevent chest infections and given physiotherapy three times a day.

In 2004, my constituent was seen by occupational, educational and speech therapists owing to his communication problems and inability to mix with peers. In 2006, he was sent back to occupational therapy and sent for a CT scan on his chest that showed fibrosis on the lower left lobe of his left lung, which was found to be smaller than his right. Between 2007 and 2009, he was diagnosed several times with pneumonia and severe chest infections requiring intense physiotherapy and antibiotics. In 2010, he was diagnosed with pneumonia again and, after admission to hospital, with hypoplasia of the left pulmonary artery, which had failed to develop.

As shocking as that story is, it is only one case, and there are many worse. I was informed of a family in which two children have been on disability living allowance since the ages of five and eight. Anyone hearing those stories can only be saddened by the personal circumstances. It is incumbent on Members from all political parties, whether in government or opposition, to ensure that we work together to get justice for those families and provide them with any necessary support.

The anti-convulsant that my constituent’s mother was given during her pregnancy was sodium valproate, otherwise known as Epilim, taken twice daily. It is clear that both the Government and the pharmaceutical companies, particularly Sanofi, could have done more and taken further action to protect the public. It was Sanofi’s duty to keep up to date with known medical knowledge, conduct further research and pass on that information to patients via the patient information leaflet. It was the MHRA’s duty to ensure that Sanofi investigated the medical research claims of birth defects caused by their products. Delays by both have resulted in thousands of women becoming pregnant without being given the necessary information on the levels of risk associated with the treatment.

Is the Minister aware that an estimated 40% of children exposed to sodium valproate during pregnancy are affected by neuro-developmental problems, autistic spectrum disorders and physical malformations, and that approximately 20,000 have been so affected since 1973? Does she think that that is acceptable? I know that her answer will be, “Of course not.” Is she also aware that this year, sodium valproate will have been licensed for 40 years, and that it is now being prescribed for other conditions, such as bipolar disorder and migraine headaches, and as pain relief? Does she think that that is appropriate, given the significant concerns raised by medical research about the drug’s use?

Mr Hollobone, you will be shocked to hear that 80 families claiming damages against Sanofi-Aventis lost their legal aid in 2010 after six years of pre-trial preparation. Their legal aid was withdrawn after assessments ruled that the group’s prospects of winning had fallen and a judicial review failed. It was a devastating blow to families who had been struggling to deal with the condition without knowing what the problem was, and without any proper support. Their lawyer, David Body, summed up the tragedy when he said that

“our case against the manufacturers of Epilim must be discontinued, not because we have lost our fight in court but because continuing without legal aid funding would place our clients at too great a financial risk.”

I know that the Minister cannot reinstate the legal aid funding, but there are other things that she can do. As an aside, we should never allow thousands of families to be affected by the malpractice of a medical company and a failure of the state, and then not give them the support that they need to find justice for their families. We should never allow a situation in which people, through no fault of their own, cannot pursue justice owing to the barriers put in their way by the system. No one who believes in the principle of fairness would think that that was just. We all have a responsibility to ensure that we support those families in bringing their action, so they can get some justice. It will not be the justice that they want, which is to have fit, healthy children, but it will be some kind of justice.

Given that successive Governments and regulators have failed to address the issue, will the Minister consider launching a public inquiry to investigate why sodium valproate and other anti-convulsants have been allowed to cause so much damage over such a long period? At the moment, there are pregnant women taking sodium valproate who are unaware of the dangers, because they did not receive pre-conception counselling. Will she confirm that she will ensure that that is corrected in future? Will she commit to working with the Independent Fetal Anti-Convulsant Trust to raise awareness of the condition? As a minimum, will she assure me that new guidelines will be issued to ensure that children exposed to anti-convulsant drugs in utero, particularly sodium valproate, are monitored closely during early childhood to allow for early intervention, diagnosis and support, should they be required? Lastly, is she or one of her colleagues prepared to meet me, my constituent and representatives of the Independent Fetal Anti-Convulsant Trust to discuss how we can support people affected by the condition, and help protect others from it in the future?

Inaction is not an option. These families have suffered for long enough, and it is incumbent on all of us to work together to find a fair deal for them, so they can get the necessary compensation, and so that we can ensure that not a single family suffers in future.

University Hospitals of Morecambe Bay NHS Foundation Trust

Eric Ollerenshaw Excerpts

Tuesday 5th February 2013 Westminster Hall

[John Woodcock]

My hon. Friend is absolutely right that that is indeed the great fear. It is up to the trust, and ultimately to Ministers and the Government, to demonstrate that that is not the case, but there are still questions to be answered.

The need for lessons to be learned has been shown by such problems as the basic lack of grip in key areas in recent years—for example, the failure of new computer systems designed to remind patients about repeat appointments, which has clearly put lives at risk. A police investigation into a number of deaths is ongoing. There is also a lack of openness at the trust.

I pay tribute to the hard work of the staff in the maternity unit and across Furness general hospital. They are dedicated people, who come to work wanting to help others and to save lives. There have been real improvements of late, and we should recognise the immense strain placed on staff by the ongoing spotlight on the hospital and the longer-term uncertainty over their future. None the less, families are still grieving because of past mistakes made in a poorly managed system. The Minister was good enough to write to me in response to a letter from my constituent James Titcombe, and again recently on the need for a genuinely independent inquiry into the lessons for the wider NHS of management failings at Furness general hospital.

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

I congratulate the hon. Gentleman on securing this debate and, as I know from having worked with him, on his concern for his constituents. Does he not think that we constantly go round the roundabout in relation to the Morecambe Bay trust? To the centre, Morecambe bay sounds as though it is a natural unit, but in fact it is a barrier. I suggest that we need to look at the fundamental geography, which might mean challenging the boundaries of the Morecambe Bay trust, if we are ever to get some balance between the demands of Furness, Kendal and Lancaster.

[John Woodcock]

The hon. Gentleman makes an interesting point, for which I am grateful. I am sure that Ministers will want to consider that, but I think it must not come at the expense of local MPs’ taking our eye off the ball in the forthcoming consultation.

The Minister was good enough to write to me about James Titcombe and other grieving families. In the first letter, he said that he would keep the issue under review. I hope that, when he has time to look at the matter further, the Minister will agree that the trust’s commitment to an independently chaired but internally managed inquiry, although it is a welcome step forward, will not be sufficient to give confidence and ensure that lessons are learned, not only in this individual hospital, but in the entire NHS. Most of all, I hope that he will join me today in sending a message, loud and clear, that the need to be accountable for past mistakes must never be used by the trust as an excuse to remove services that our community clearly needs.

The final part of my speech relates to the crisis caused by the trust’s shock decision to transfer, apparently temporarily, the special care baby unit and consultant maternity services out of Furness general to Royal Lancaster infirmary due to increased sickness absence levels at the trust.

Let me deal first with the shambolic process that has left expectant women unsure about where they can give birth—even now, as we speak, two hours after the transfer was due to take place—because of genuine fears about a lack of ambulance cover. The decision was taken unilaterally by the trust, with no consultation or warning given to the public, the obstetric consultants who work at Furness general, or the GPs responsible for commissioning the services. The option of transferring staff from the Royal Lancaster infirmary was not put to the board. Although there can be no doubt that staffing levels are low at Furness general, there was no detailed risk assessment of the dangers of transferring mums in labour by ambulance. Most alarmingly, no attempt was made to engage the North West ambulance service—this was confirmed to me by the service last night—until last Wednesday evening, leaving that organisation unable to find the extra unit that it estimates will be necessary to cope with the increased demand on an already stretched operation. This is an appalling and potentially dangerous shambles that has greatly increased the anxiety of pregnant women in my constituency, on top of the worry they already felt at the news, during what is naturally one of the most worrying times in their life anyway.

Will the Minister intervene personally to impose order on the chaos? Will he confirm that the regional health authority’s gold command is meeting today to escalate the situation? Will he meet me to ensure that we have the best chance of getting the services we need back as soon as possible? Let me be clear: families in my constituency and beyond will be devastated if we lose consultant-led maternity services permanently. The Minister is a practising obstetrician and will know better than I that the removal of the clinician-led special care baby unit will result in women who expect complicated deliveries or who experience complications during birth facing a transfer to Lancaster, involving a journey time of about one hour along a road that, less than a fortnight ago, became almost impassable due to heavy snow—in fact, journeys between Barrow and Lancaster were taking up to 10 hours. Trying to transfer a mother who needs consultant care in such conditions is hard to imagine.

It has been suggested that air ambulances could be used to speed up transfer times in the event of Furness general hospital’s maternity unit being downgraded, but serious questions need to be answered about the practicality of that proposal. The Great North air ambulance service is a fantastic organisation that helps to save many lives each year, but it has just three helicopters to cover not only Cumbria, but the whole of north-east England and North Yorkshire. We cannot simply assume that the answer lies in the air.

I am immensely proud to be backing the “Thousand Voices” campaign in my constituency, which comprises mums who got together to make themselves heard when they saw the crisis coming. I know that I cannot use props, Mr Howarth, so I will not, but I urge all hon. Members to go to www.YouTube.com/saveFGHmaternity to hear the stories being shared. People are going out and using camera phones to get video clips from mums and dads, wherever they can find them. Let me read just one such story on the site, which reflects the views of hundreds. Mum of three, Christina Pickering, said:

“Due to extreme circumstances in my third pregnancy, I was sent to the Royal Preston hospital to deliver my daughter and that’s got to be one of the most terrifying experiences of my life, being in an unknown hospital, on my own, to deliver my baby. I don’t want this to happen to any mums—it doesn’t have to. Downgrading our maternity services at Furness general would not only be detrimental to mums and babies, but to the whole community. We’ve got to stop this happening.”

Let me end with the Minister’s own words from before he was promoted, which I wholeheartedly endorse. In a Westminster Hall debate in September 2010, he said that,

“generally speaking, if we consider the example of”

other hospitals,

“we see that the push has been to have a low-risk, midwifery-led unit alongside a higher-risk unit. We in obstetrics know that a greater number of women—rising to about 30%—are giving birth by Caesarean section, and that number is going up year on year. Many births that we initially think uncomplicated end up being much more complicated.”—[Official Report, 14 September 2010; Vol. 515, c. 230WH.]

The Minister summed it up perfectly. Families in Furness want the security of knowing that they can have their babies in Barrow with specialist help on hand. They pay for their health services with their taxes and they are speaking with one voice. They need the Government to listen.

Oral Answers to Questions

Eric Ollerenshaw Excerpts

Tuesday 15th January 2013 Commons Chamber

[Dr Poulter]

As my hon. Friend knows, we are developing the 111 service further to improve triage and take pressure off accident and emergency services when that is appropriate. I am sure all Members agree that when patients do not need to go to A and E, it is best for them to be treated in the community or properly triaged.

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

11. What steps he is taking to improve the recruitment and retention of specialist accident and emergency doctors.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

That is a long-standing problem. Recognising that emergency medicine is moving towards becoming a 24-hours-a-day, seven-days-a-week service, the Government have set up an emergency medicine task force to tackle the problem and encourage more recruitment of middle-grade doctors to A and E specialties.

[Eric Ollerenshaw]

Might it be time for us to take a leaf out of the Department for Education’s book, and consider offering scholarships or bursaries tied to doing the job for a certain number of years in order to improve recruitment and retention in this difficult area?

[Dr Poulter]

Bursaries are already available to medical students to encourage recruitment to the medical profession. As for the specific question of A and E recruitment, at the end of last year I published—alongside the report from the Doctors and Dentists Review Body on the consultant contracts and clinical excellence awards—a report on junior doctors in training. That has given us an excellent opportunity to consider what rewards and inducements may be available to encourage junior doctors to move into A and E and other specialties in which the work is particularly intensive and the meeting of staffing requirements has posed a long-standing challenge.

Vascular Services (Wycombe Hospital)

Eric Ollerenshaw Excerpts

Monday 14th January 2013 Commons Chamber

[Steve Baker (Wycombe) (Con)]

I am most grateful to you for that, Mr Speaker. I am also grateful to my hon. Friend the Minister for being here at this hour to discuss vascular services in Wycombe hospital, as I know he has thought carefully about the subject. It is a subject that will be of interest to your constituents, Mr Speaker, so I am glad to see you in the Chair, and to my right hon. and learned Friend the Member for Beaconsfield (Mr Grieve), a number of whose constituents campaign vigorously on the issue, so I am glad to see him here supporting this case. The nub of the issue is that we in Wycombe have been told repeatedly that it is in our interests for hospital services to be centralised away. There is today a clear momentum to centralise vascular services for the Thames Valley in Oxford, yet Wycombe enjoys better results and Oxford has been subject to a range of criticisms, as I shall set out.

We need to look at the historical context to understand why the opposition to what is happening is so vociferous. Wycombe hospital is in a position perhaps typical of a generation of district general hospitals: we lost our accident and emergency unit; we lost consultant-led maternity, retaining a midwife-led unit as a concession; we lost paediatrics; and in 2012 the emergency medical centre—the EMC—was downgraded to a minor injuries unit, repeating much of the local outcry about the loss of the accident and emergency unit. At each stage, campaigners expressed fears that the withdrawal of services would lead eventually to the closure of the hospital. At each stage, those fears were vigorously stoked by dissenting voices among the affected medical staff. At each stage, the NHS management no less vigorously denied that such an outcome could ever occur, and after each stage the NHS management went on to propose further service withdrawals. It is no wonder so many local people fear closure.

In Wycombe, we do have the Buckinghamshire units for cardiology and stroke, which treat two of the biggest killers, but, scandalously, the minor injuries unit recently failed to admit a lady who arrived with suspected heart trouble—the Minister will recall taking my question in the House on that occasion. It is now being suggested by some clinicians, specifically those within the vascular unit at Wycombe, that losing vascular services at the hospital could threaten those excellent services we have left.

I feel sure that the Minister will appreciate the excruciating sensitivity of this issue. The long, grinding decline of our hospital has sown anger, despair and cynicism, not least because the public have come to appreciate that NHS consultations seem to be exercises in manufacturing consent—or perhaps the appearance of consent—rather than providing democratic accountability and control.

The recent “Better Healthcare in Bucks” consultation on the downgrade of the EMC mentioned vascular services, supporting the view that vascular should remain in Wycombe until a review in 2014. We are now approaching that review and a series of leaked documents has shown two important points: first, vascular care in Wycombe is superior to that in Oxford; and, secondly, the transfer of vascular services to Oxford is essentially a done deal.

Let us consider how vascular services have changed, because I know that it has affected many of my hon. Friends and Opposition Members. Diseases of the arteries and veins used to be treated by surgery only, but problems are now reached via other blood vessels using techniques known as interventional radiology. Vascular surgeons and interventional radiologists support cardiology, cardiac surgery, stroke and other disciplines. The new vascular specialty was approved by Parliament in March 2012. Vascular is now listed as a specialty on the General Medical Council website, although the approved curriculum and assessment system was not available today. There is also a Vascular Society.

According to the authors of a report on the centralisation of vascular services in Oxford,

“the advent of separate specialty status for vascular surgery together with speciality commissioning plans for 2013 onwards…will reduce the number of hospitals providing vascular surgery to about 50 in England and Wales”

from 150, and

“commissioners will not purchase arterial interventions except from arterial centres.”

I think that is why the issue has affected so many of my colleagues.

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

I congratulate my hon. Friend on securing this important debate. In north Lancashire, the situation is similar. It is perhaps not the policy that is the problem but the implementation of it, because if it is implemented some of my constituents, particularly in rural areas, will face transport times of more than one and a half hours. The national target for improvement is just one hour, which is why, unfortunately, I have to support my local hospital, the Royal Lancaster infirmary, which has reached the point of considering taking the implementation of the policy to judicial review.

[Steve Baker]

My hon. Friend raises an important point about transport, which will be an issue for many of our constituents, not least because they will not have cars.

People in need of vascular care will include those with abdominal aortic aneurysms, a life-threatening weakness of the main artery that must be repaired, and those who have had strokes or mini-strokes—transient ischaemic attacks. After a stroke, drugs are administered immediately, but they need to be followed up with a procedure to clear the carotid artery, called a carotid endarterectomy or, mercifully, a CEA. Other people requiring care will include those with poor blood supply, including smokers and diabetics, who might endure serious complications that might even lead to amputation.

Wycombe hospital provides the full range of services. It is proposed to move them all to Oxford university hospitals on the basis that the present arrangements are “not sustainable”, but I have yet to see evidence that supports that assertion. Leaked documents suggest that Oxford provides worse outcomes and is struggling to be ready.

Pancreatic Cancer

Eric Ollerenshaw Excerpts

Wednesday 23rd May 2012 Westminster Hall

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

Thank you, Mr Scott, for calling me to speak; it is a pleasure to serve under your chairmanship. I am pleased to have secured this debate, as it is on a subject of huge importance to thousands of families across the UK. It is also a subject that is close to my heart.

This debate was originally scheduled for the last week of the previous parliamentary Session. However, the cause of Prorogation it was cancelled, so I am particularly lucky to have been drawn again so quickly. Whether that was because of pure luck or the Speaker’s Panel taking pity on me, I do not know, but I am grateful none the less.

As it happens, the timing for this rescheduled debate could not have been better, because last week we established the all-party group on pancreatic cancer. It is chaired by Lord Patel, the Cross-Bench peer, who has huge experience of the medical profession, and it has a most fantastic treasurer in the hon. Member for Scunthorpe (Nic Dakin), who is here in Westminster Hall today. The all-party group aims to work with Pancreatic Cancer UK, Cancer Research UK and others to increase awareness of pancreatic cancer, and to help campaign for better care and treatments, which will lead to improved outcomes.

The simple fact is that we need better care and treatment. The number of people diagnosed with pancreatic cancer is rising. In 2008, around 8,100 cases were diagnosed—about 22 cases a day. Compared with other types of cancer, those numbers are quite low. However, there is a very poor prognosis in pancreatic cancer cases, with only 3% of patients surviving for five years or more. In my own particular case, my partner survived for only seven weeks after being diagnosed.

Despite advances in technology and improvements in survival rates for other forms of cancer, that figure of 3% has remained unchanged for 40 years, which is quite incredible. There are also wide regional variations in UK survival rates, the so-called and much cited problem of “the postcode lottery”. On a national level, that survival rate—only 3% of pancreatic cancer patients in the UK survive for five years or more—is the worst in the developed world. To put it into context, it is half the survival rate of the US, Australia or Canada. Those countries’ survival rates are obviously still low, but they are much better than the British survival rate.

There have also been reports from people with pancreatic cancer that the care provided in the UK has fallen below expectations. The 2010 NHS national cancer patient experience survey found that pancreatic cancer patients fared significantly worse than patients diagnosed with other cancers. That needs to change. Some things will be easier to rectify than others. For instance, improving the patient experience seems an obvious and relatively easy thing. However, we can and should work on improving awareness, diagnosis, treatment, care and—ultimately and most importantly—the survival rate across the board.

One can look at the impact of the advertising to increase awareness of bowel cancer, which is a difficult cancer to deal with. We are looking to achieve a similar impact in terms of increasing awareness of pancreatic cancer. Increasing awareness is vital, because too often pancreatic cancer is diagnosed at far too late a stage. Although symptoms may have manifested themselves for several months, many people do not visit their doctor until it is too late and the disease is quite advanced. In fact, 50% of pancreatic cancer patients are diagnosed only as a result of an emergency hospital admission and more than 80% of pancreatic cancer patients are diagnosed only once the tumour is inoperable. Those are startling, sobering and depressing statistics.

Let me refer again to my personal situation, in which the pancreatic cancer was diagnosed only after a series of what were just stomach aches, and tests were carried out only after those stomach aches and after a number of visits to the GP.

For the record, the symptoms of pancreatic cancer can be quite vague and varied. They can include weight loss and pain in the stomach, which both appeared in my particular experience of the disease, as well as back pain and jaundice. But if someone does not have any knowledge of the disease—neither I nor my partner had any such knowledge at the time—how would they realise that, because one is feeling tired every day there is something particularly wrong, until the stomach aches develop? Even then, in my personal experience the stomach aches were not significant in terms of pain. We had no awareness that that feeling of tiredness was anything to do with cancer.

We need to ensure that doctors are making the right diagnosis. Nearly 30% of pancreatic cancer patients will have visited their GP five times or more before being properly diagnosed; that was true in my situation. So we need to make sure that GPs are provided with the proper tools and training to recognise the symptoms of pancreatic cancer. Moreover, we need to ensure that GPs are able to refer their patients swiftly to hospitals for further tests when they suspect a case of pancreatic cancer.

As part of that process, Pancreatic Cancer UK is holding an early diagnosis workshop next month. Hopefully, that workshop will help to come up with more concrete actions that could be taken. I understand that the Minister’s colleague, the hon. Member for Sutton and Cheam (Paul Burstow), has agreed to support that workshop, which is an encouraging sign.

Put simply, late diagnosis means that the few treatments available might not be an option, so it is absolutely imperative that we improve awareness and diagnosis.

Let me turn to treatments. The uncomfortable fact is that few options for curative treatments exist. One of the reasons why survival rates for pancreatic cancer are so low, compared with those for other types of cancer, is that pancreatic tumours are relatively highly resistant to chemotherapy. Having said that, I note that Cancer Research UK has said that it believes there is some kind of breakthrough in terms of a new class of drugs, details of which it announced in April; that new class of drugs looks quite promising in terms of being able to improve treatment.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing this debate on a very important issue; every one of us will have constituents who will be affected by it. Does he share my concern—and, I suspect, the concern of many people—that pancreatic cancer is the fifth most deadly cancer in the whole of the UK and yet only about 1% of cancer research is on pancreatic cancer? Also, does he feel that it is now time for the Minister to work with all the regional bodies across the UK—the Scottish Parliament, the Welsh Assembly and the Northern Ireland Assembly—to introduce a UK-wide strategy to reduce deaths from pancreatic cancer?

[Eric Ollerenshaw]

The hon. Gentleman can obviously read minds, because that point about research is in my next paragraph. His other suggestion about a UK-wide strategy is a really interesting and positive one, because pancreatic cancer obviously does not respect any boundaries, or any devolved Government or national Government. So he makes an interesting point, which the all-party group can perhaps consider.

Effective cures for pancreatic cancer remain stubbornly elusive, but we need to try to find ways to prolong patients’ lives and to ease their pain and suffering, while always remembering that, with cancer, it is not only the patient who is affected but the people around them, including their family. Cancer affects not just one person; its effect spreads to other people. I had not entered the cancer world before my own personal experience—I call it a separate world, because it is like entering a separate universe that has never been experienced before. Patients’ loved ones also experience suffering.

[Stuart Andrew (Pudsey) (Con)]

First, I congratulate my hon. Friend on securing this very important debate. I know how personal this issue is to him. Linked in with the point that he has just made, does he agree that this issue shows why it is so important that we have a strong hospice movement in our country? That is because hospices have the expertise and are able to treat conditions such as pancreatic cancer with a holistic approach, so that it is not only the patient but the extended family and loved ones who receive support—support that they need, too.

[Eric Ollerenshaw]

My hon. Friend represents Pudsey, a Yorkshire constituency, so he says it like it is. I will go on to say something about hospices; what he said about them is true. In a sense, for a lot of families cancer is almost like the end. With pancreatic cancer, proper treatment is vital and nobody should underestimate the work of the hospice movement. As I say, I will go on to say a couple of things about hospices.

[Nic Dakin (Scunthorpe) (Lab)]

I congratulate the hon. Gentleman on securing this very important and timely debate. I also pay tribute to his passion for this issue and to the personal experience that he brings to this debate; he brings real understanding. In addition, I pay tribute to Pancreatic Cancer UK, which is doing excellent work, and to campaigners such as Maggie Watts, a campaigner in my constituency. She has direct experience of this issue and is driving an e-petition forward on it.

Does the hon. Gentleman not agree that we need more support from the Government in the area of research into cures? Only 1.6% of research funding is spent on pancreatic cancer, and the Government can move things forward here.

--- Later in debate ---

[Eric Ollerenshaw]

I thank my colleague from the all-party group for his intervention. Like the hon. Member for Strangford (Jim Shannon), he seems to have a copy of my speech—my next paragraph is about research funding. We are all in this together, as it were, particularly on this one.

The point that the hon. Member for Scunthorpe makes so well is that more research into the cancer is absolutely imperative, to find new and more effective treatments. Pancreatic cancer receives just 1% of cancer research funds, despite being the cause of 5% of cancer-related deaths. More research funding will help us discover why this type of cancer is so resistant to treatments that can cure other forms of the disease, and identifying early markers will help to establish screening programmes and lead to earlier diagnosis.

In addition to funding new and expanded research programmes, it is key that we increase patients’ take-up of clinical trials. According to the National Cancer Research Network, fewer pancreatic cancer patients enrol in trials than people with other cancers. I do not know whether that is due to the poor survival rates, but it is fundamental that we encourage more of those patients to take part if we are to get the research we need.

Finally on the subject of treatment, we desperately need to find out why there are such regional variations in survival rates. I am sure that the hon. Member for Scunthorpe will agree that the amazing thing at last week’s inaugural meeting of the all-party group was the personal evidence from three survivors from different parts of the country.

One survivor in particular had had to push doctors and fight to get the treatment, and he ended up—I think he came from the midlands—in Reading or somewhere in the south. That was due to his own perseverance, however, and it should not be like that, because once there has been a diagnosis of cancer everything goes to pieces for the family and friends. That man’s will was the most powerful thing about that meeting; he is living evidence that something can be done. We need to ensure that GPs learn from successful parts of the country and that effective procedures are copied wherever possible. That will need top-down leadership, and I hope that the Minister will be able to comment on how that matter is being addressed.

Treatments, including surgery, for pancreatic cancer are few and difficult, but that is no excuse for poor patient experiences. The 2010 NHS national cancer patient experience survey found that pancreatic cancer patients fared significantly worse than those diagnosed with other cancers. For instance, nearly a third of pancreatic cancer patients said that they felt their diagnosis should have been communicated more sensitively, compared with 18% of all survey respondents. The survey also showed that 41% of pancreatic cancer patients were not given information about their cancer when it was diagnosed, compared with 27% of all respondents.

Although I was given a great deal of support, for which I pay tribute to Homerton hospital in Hackney—I will come on to talk about cancer specialist nurses; we had a brilliant one—when coming back from surgery to relieve some fluid, my partner, who was slightly drugged up from the operation, asked the doctor, “How is it?” and he simply turned around and said, “It’s terminal.” That was the first time that either I or my partner had been so informed.

I do not know why doctors find it harder to explain things to pancreatic cancer patients than to other cancer patients—perhaps it is because of the low survival rates—but although effective treatment might not always be possible, we need to do more to improve the patient experience and, as I keep saying, that of family and friends. Other than by way of better information being more sympathetically delivered at the point of diagnosis, that can be done through the support and care provided by clinical nurse specialists. We were lucky, because there was a cancer specialist nurse in the hospital, who guided us through what was going on. The national cancer patient experience survey, which is proving to be a fundamental part of my speech, also found a link between positive patient experiences and access to a clinical nurse specialist. Is the Minister able to comment on that?

I should state that although there can clearly be improvements in patient care, with such low survival rates much of the care can end up, as my hon. Friend the Member for Pudsey has said, being provided in hospices. My experience of St Joseph’s hospice in Hackney was for only two days and two nights, but it was unbelievable, and I pay tribute to everything in the hospice movement. The treatment is holistic, with the family and everyone involved.

As some kind of conclusion, I want to place on the record how grateful those of us who have personal experience of this dreadful disease are to charities such as Pancreatic Cancer UK and Cancer Research UK, which drive the case for change and generally help to give people hope that the situation will improve in the future. Also, we should all pay tribute to the doctors and nurses who provide care and treatment for sufferers, especially in their last days, and I again praise the hospice movements. Their efforts and attitude help to make an extremely difficult time for patients and their friends and family a little more bearable—if it is bearable.

With my personal situation, the biggest thing I would underline is my description of going along in life and assuming that everything is okay and then entering this kind of cancer world, with cancer specialists. The support from other people who are going through the same thing as well is unbelievable, but in 2012, with an NHS of which we are all so proud, why is there such variation, and why has there been no improvement over 40 years in dealing with this virulent form of cancer? I would be grateful to hear what the Minister has to say.